TSU supported the formation of a national and regional formal VMMC program coordination structures in the first year. At National level, a National TWG (NTWG) and at regional level, an Inter County TWG (ICTWG) and at county level, County TWGs (CTWG) were formed in each of the five priority Counties. The TWG’s ensure that VMMC guidelines and strategic plan objectives are implemented effectively.

TSU team provided leadership in the development of National Technical Working Group (NTWG), Inter County Technical Working Group (ICTWG) and County Technical Working Groups (CTWG) TORs for the 5 priority Counties. The TORs for 2/5 counties (Migori and Homabay) have been endorsed and signed by the County Executive Committee (CEC). The TOR for NTWG and ICTWG is awaiting approval by the Director of Medical Services, Ministry of Health. TORs for the sub committees on monitoring and evaluation, service delivery and communication have been developed and endorsed by the NTWG

The membership of TWGs have been expanded to include; Head, Division of Reproductive Health, Head, Division of Child Health, CEO, National Council for Population and Development and Head, Division of Health Records and Health Promotion officers.

The NTWG held 4 meetings (once every quarter) in the last one year. The meetings were chaired by the Director of Medical Services, ministry of Health, Kenya or his nominee.

The ICTWG held 2 meetings (semi-annually) in the last one year and was chaired by and Kisumu County Chief Officer of Health.

The CTWGs are supposed to meet quarterly and the meetings chaired by the County Directors of Health. However, Homabay held 1 meeting, Kisumu held 3 meetings, Siaya held 2 meetings, Migori held 2 meetings and Nairobi held 1 meeting during the reporting period.

Meeting minutes are now documented and archived by the CASCOs and copies retained by NASCOP through the TSU/VMMC Regional Coordinator. TSU team follows-up on action points emerging from the NTWG and CTWG meetings through the sub committees and regular meetings with the CASCO’s and VMMC focal point persons

To sustain coordination roles of TSU the County Technical Working and the CHMT has appointed a VMMC focal point person in each county who is tasked with supporting the CASCO in operationalizing of VMMC activities within the Counties. The VMMC focal point person collaborates with partners and other key stakeholders to implement and coordinate VMMC activities.

Training of MOH staff in 5 priority counties conducted on the reviewed VMMC M&E tools and reporting. To ensure VMMC indicators are consistently captured the TSU M&E Field Officer is mentoring County Health Records & Information Officers to mainstream VMMC data into HMIS (DHIS2). VMMC indicators and targets are reviewed with other facility indicators during data review meetings.

TSU Field Officer for communication worked with County Health Promotion Officers reviewed the second communication VMMC strategy and has reviewed VMMC IEC materials as well.

VMMC programme M&E framework has been developed and integrated within the National Program M&E framework

TSU supported NASCOP to conduct a baseline assessment and mapping of VMMC services nationally. All facilities providing VMMC were mapped. The mapping exercise also outlined the gaps in VMMC programme in the country. 215 sites (14%) both public and private provide VMMC services out of 1497 available facilities in the 5 priority counties. Of the 215 sites, 159 (74%) provide static services and 56 (26%) provide outreach services. Over 95% facilities implementing VMMC activities are linked to the HMIS and DHIS. The mapping report is used by the NASCOP to:

Identify gaps that requires strengthening

Identify opportunities for improved coordination of VMMC activities

Guide in revising work plans for improving coordination mechanisms and VMMC programme integration

Inform VMMC program targeting, scale-up and rollout with the new devices

NASCOP in collaboration with the ICTWG, NTWG, CTWG and the CHMT has ensured institutionalization of quarterly internal quality assessments in the 10 NASCOP priority counties. This is done using the EQA tool which was reviewed and adapted.

The concept note on COE has been developed and approved by the National Technical Working Group. 16 sites were identified from the 4 Counties in the Nyanza region to be reviewed and shortlisted. TSU supported NASCOP in developing a facility assessment tool to review the identified institutions and actively participated in assessments. Three facilities were shortlisted from 16 facilities initially assessed. These three facilities were Lumumba County Hospital, Homa Bay County Referral Hospital and Jaramogi Oginga Odinga Referral hospital.

TSU engagements with KMTC has led to the approval of inclusion of VMMC training into the preservice curriculum for nurses. VMMC training will be included into the KMTC Nursing curriculum as a module and there after have a competency training during exit.

Integration and advocacy concept note have been developed and shared with County Health Management teams, County TWG, Inter County TWG and Donors. A consensus development meeting has been planned to seek consensus on integration road map and integration models.